Cerebral hemodynamics after hemorrhagic shock: Effects of the type of resuscitation fluid

G. V. Poole, J. C. Johnson, D. S. Prough, D. A. Stump, E. H. Stullken

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Abstract

Cerebral blood flow (CBF), cerebral oxygen delivery, and intracranial pressure were measured in 12 dogs subjected to hemorrhagic shock and then resuscitated with lactated Ringer's solution or 6% hetastarch. Hemorrhagic shock was produced by the rapid removal of blood to achieve a mean arterial pressure (MAP) of 40 mm Hg with BP maintained at that level for 30 min. Six animals were resuscitated with lactated Ringer's solution, 60 ml/kg iv, and six with 6% hetastarch, 20 ml/kg iv. Both solutions effectively restored systemic hemodynamic stability, increasing cardiac output and MAP. Intracranial pressure was significantly (p < .05) lower after resuscitation in the hetastarch group, but CBF, which had decreased during shock, was not normalized by either fluid, and cerebral oxygen transport fell further with resuscitation secondary to a hemodilutional reduction of hemoglobin. Although 6% hetastarch may improve systemic hemodynamics and maintain a low intracranial pressure during resuscitation, it fails, as does lactated Ringer's solution, to restore cerebral oxygen transport to prehemorrhagic shock levels.

Original languageEnglish (US)
Pages (from-to)629-633
Number of pages5
JournalCritical care medicine
Volume14
Issue number7
DOIs
StatePublished - Jan 1 1986

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ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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